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That fear helps to explain how universal male suffrage ‘inverted the political dynamics of arguments about secret voting’ (19) and led to the adoption of what would become known as the Australian ballot. Widely emulated around the world, it was celebrated for turning ‘voting into a well-mannered civic ritual’ (25). The story of who gets to participate in this civic ritual, the practicalities of that participation, and how that vote is counted, provides Brett with a broad palette with which to paint a rich and sometimes difficult picture of Australia. Central to this difficulty is the contradiction between the expansion of the franchise for the white majority on the one hand, and its contraction for Aboriginal and Torres Strait Islander people and non-white minorities, on the other. While the former gave some legitimacy to the boast of Australia as a ‘democratic laboratory’, the latter complicates (and I would argue, prevents) favourable foundation narratives of settler-colonial societies. In navigating this path, Brett addresses head-on the attempt to disfranchise Aboriginal and Torres Strait Islander people in the passage of the Commonwealth Franchise Act (1902). She draws attention to the fact that this exclusion was not part of the original bill; its insertion the result of ‘political calculation and racism’ (66). In the end just five parliamentarians voted against the bill (Deakin was absent from the chamber): James Ronald, Hugh Mahon, Billy Hughes, Vaiben Louis Solomon and Henry Willis. Brett singles out Ronald’s impassioned speech: ‘To draw a colour line, and say that because a man’s face is black he therefore is not able to understand the principles of civilisation, is misanthropic, inhumane and unchristian’ (64–5). Here, at least, is something positive to cling to in our founding story. There are, of course, many other things to which we may cling, but their successes – such as the franchise for white women – ring hollow without their universal application. The White Australia Policy and the exclusionary nature of Australia’s egalitarianism cast a long shadow. From Secret Ballot to Democracy Sausagewill be invaluable to students of politics seeking an accessible history of Australia’s electoral system. In taking a long view we can understand why the introduction of postal voting was disputed; how proportional representation changed the dynamics of Australian politics; and what the growing influence of minor parties means for Australian democracy. Brett is right to remind us that the adaptations along the way in our electoral history, both big and small, now make it easier for citizens (but not residents) of Australia to cast a ballot than almost anywhere in the world. But the exclusionary impulse that substituted race for class continues in other guises. For Brett, the evolution of Australia’s electoral system is, with caveats, a success story. And here there is much to debate. The largely genial nature of Australia’s present-day Saturday voting rituals notwithstanding, I drew different conclusions from the author: that our faith in parliamentary processes is misguided, that the attainment of a vote doesn’t equal full participation in the wider polity, and that it’s time we ditched Bentham and got ourselves a Bill of Rights.


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Prof. Bichat's Researches on Life and Death. rit of acquainting the public with the true qualities of a phyfician, by which it may be enabled to judge in fome fingle inftances, yet on the whole, it would require a greater knowledge of the me* dical fcience than can be expefted, but without which, however, it will be impoilible to difcover any miltakes or errors that a phyfician may commit in the treatment of a difeafe. After having premifed fome juft remarks on the too great number of thofe who devote themfelves to medicine, and on the different means and expedients by which yonng do&ors attempt to introduce themfelves into pra&ice, the author treats, in the jirft J'eftion, of the perfon of a phyfician. Ch. I. Of the exterieur of the phyfician, to which he refers his phyfiognomv, drefs, and manners. Ch. 2. Of the phyftcal qualities of a phyfician. Medical art being founded upon experience, and accurate obfervation of things that are obvious to our fenfes, a phyfician ought to poffefs them in a moll perfeft ilate; this the author fhows of every fenfe in particular. Ch. 3. Of the moral qualities, judgment, &c. of a phyfician. Humanity, patience, modefty, ftcrecy, and moderation, are the principal virtues at which a phyfician fhould particularly aim ; befides a comprehenfive genius, he ought to have a good memory, and a knowledge of the dead and living languages. The fecwd fed ion treats in three chapters, of the conduft of the phyfician towards his colleagues, towards furgeons and apothecaries, and towards the patient; upon the laft of which he particularly dwells; and we meet every where with remarks that are confirmed by experience. At the end of the preface the author promifes to prefent to his readers a fketch of the Brunonian fyltem, a circumflance which lhould not furprife us, as the author is known to be one of the principal partizans of the Brunonian theory, and confequently in-$erefted in its acquiring the molt extenfive popularity. Recherches Phyjiologiques fur la Vie et la Mort j i. e. Phyfiological Refearches on Life and Death; by Xav. Bichat, ProfelTor of Anatomy and Phyfiology. Paris,Year vl 11. in two vol. 8vo, price 5 francs, or about 5s.
We here announce a new work on two interefting fubje&s o^ the organic doflrine, life and death, which, on account of its general excellency, deferves a more copious notice. The author at-1 tempts to enquire into the Zoonomick laws by analyfis and llridl induction, and has, indeed, given light on feveral obfcure do&rines of phyjiology, by his vivifeftions, and other ingenious experiments ; though, on the other fide, he has frequently fuffered himfelf to be deluded by a luxuriant imagination, and to be milled by an acutenefs more fubtle than true, with which he endeavours to force Nature into fyftematical bonds, which are frequently difregarded in a fubjedl that will never allow itfelf to be conitrained by fyftems. there exifts, confequently, a continual viciffitude of action and reaction in the living body. Life fhows two principal modifications, an organic or internal life, and an animal or external one, (<vie animals, cu de relation) the firft of which is common both to animals and vegetables, comprehending their exigence, nutrition, growth, aflimilation, digeftion, fecretions, and excretions; the fecond belongs to men and animals, by which they are enabled to perceive, to move voluntarily, and to exprefs their defires and paffions; in one word, to connedt their exiltence with other beings. Each of thefe two kinds of life has again two orders of functions. The firft order of the animal life proceeds from without, towards the brain ; the fecond, from the brain towards the organs of locomotion and of voice. By the firft order of fundlions in the organic life, the nutritive fubftances are affimilated, to which belong digeftion, circulation, refpiration, and nutrition: By the fundlions of the fecond order, the particles that have become heterogeneous to organization are removed; abforption, circulation, perlpiration, and fecretion. The fyftem of circulation, as the centre of the organic life, belongs to both orders.
Art. 2. Chief differences of the tivo lives, nvith regard to the forms of their respefli-ue organs. The greateft iymmetry prevails in the organs of animal life ; whereas thofe of the organic life are extremely irregular. By a line drawn along the middle of the human body, the organs of the firit life, brain and nerves, will be feparated in two equal parts, which are not ftridlly dependent on each other, as we fee, /or inftance, in hemiplegia; but in the organic life, every part is combined and fubfervient to each other; their form and fituation are, at the fame time, more frequently changed than in the other. The ideal of this law, the author firft difplayed, with a great deal of acutenefs and ingenuity, in the Memoirs of the Medical Society at Paris; however, it is liable to many objections that may be juftly raifed againft it.
Art. 3. Chief difference of the tivo lives, nvith regard to the mode of ailion of their respeflive organs. The aftions of the organs of animal life proceed with the greateft proportion and harmony, which feems in a great meafure to be owing to their fymmetrical ' fituation and form. The author, in ftridtly examining this law, meets with feveral exceptions, which, however, he endeavours to explain with much acutenefs. The apparent inequality between the actions of the mufcular fyftem of the right fide, which is thought to enjoy more ftrengtn than that of the left, is not founded in nature, but merely produced by the cuftoms of fociety. In the mode of adtions of the organic life, however, the greateft difference prevails, as one organ is frequently larger than another, and performs its functions better than another; one kidney is often larger than the ether, and fecretes more urine, Sec.
Prof-Bichaf s Researches on Life and Death.
Art. 4.. Chief difference of the two lives, -with regard to the duration of their actions. The functions of the organic Jife proceed in a continual progreflion, whereas in the animal life, an intermiflion takes place : The author attempts to elude feveral objections that may be propofed againlt this law, which does not at all appear to be founded upon obfervation. It cannot be well afferted, that all influence of the nerves, upon voluntary mufcles, ceafes when they are in a quiet flate, or on the organs of fenfes during fleep. Art. 5. Chief difference of both lives, nvith regard to cujlcm and habit. Cultom diminifhes the perception and fenfe of pain and pleafure, but it brings the judgment to a' greater perfection : The power of habit does not extend to the organic life, and the circulation, refpiration, and perfpiration, are not influenced by it. The author, however, does not omit to remember the great power of habit in eating and drinking, return of appetite, excretio alvi et urinae, on which account he refers them to the phenomena that keep the medium in both lives.
Art. 6. Chief difference of both lives, nvith regard to moral properties. Ail operations of the underftanding are fituated within the compafs of animal life, but the paflions are ruled by the organic life, whofe found and morbid ftate, different degree of ftrength, and the predominant functions of any org^n, have a remarkable influence on paflions and temper. The influence of violent paflions on the mufcular fyftem, ought to be explained, according* to our author, from the more or lefs vehement influx of blood "into the brain, and the locomotive organs, &c. But as the debilitating and deprefling afteCtions of the mind do always leave vifible impreflions in tne voluntary mufcles, particularly of the face, and as, befides, leflons of the inner organs produce convulfions and palfses of the extremities, the author is obliged to adopt a fympathetic connexion between the organs of the internal life and the brain, in order to explain thofe phenomena. He denies that the paflions arife from the centrum epigajiricum of nerves, an opinion which fome modern phyflologifts have adopted : He adds, however, fome very ingenious remarks on the great fympathetic nerve, in which he difplavs at the fame time a profound knowledge of t>f the finer anatomy. Art. 7. Chief difference of the tivo lives, 'with regard to the vital ftoivers. The vital powers are not fubjeCt to phyflcal laws; extenflbility, a property of the tela cellulola, which even remains after death, differs greatly from fenfibility and contractility. The firft, however, is of a different character in the two lives, becaufe in the organic life it confifts in the faculty of receiving imprefiions, but. in the animal life of conducting them to a common central point; and though this animal and organic fenfibility agree in their chief character, yet they feem to be diiti.nguifhed by the degree and proportion with which they aCt. ContraCtility may be i^parated into animal and organ:c ; the firft of which is influenced by the will, and begins in the fenforium commune; the^fecond exifts in the different organs, and admits two modifications, the perceptible and imperceptible contractility.
Arts 479 Art. 8. Origin and progress of the animal life. The adlivity of the organic life begins in the firft moment of exigence, but in the embryo animal life cannot be traced. The adtions of the animal organs come to perfection by degrees, whereas the organic ones perform their functions from the firft moment to the end with equal perfedtion and accuracy. The new-born animal ftaggers in walking and Handing, while its ftomach digefts well, 'and the glandular fyftem adts in juft proportion.-Art. .9. Origin and progress of the organic life. The fundlions for affimilation are very Ample in the fetus, and proceed very quickly, as the nutritive particles enter into the fetus after being prepared in the mother. The fecretions and excretions are flow and inconfiderable ; but as the inner organs receive immediately the juft degree of adtion, none of them ftiould properly excel the other, or become ftronger or weaker. This, however, is not found to be fo ; the liver, for inftance, frequently rules other organs, whence the varieties in the temper.
Art. 10. Natural death, cf both lives. The fame difference which they ihow in their beginning and progrefs, are alfo remarked ia their ending. Animal life ceafes in natural death a long time before the organic. The talte remains the longeft. Mankind approaches, in the bofom of the mother, and at the verge of life, to a plant. Natural death has two periods, in the firft of which refpiration and circulation ceafe together with the animal life ; in the fecond, the reft of the organic fundtions, but by degrees and flowly. The digeftive power of the ftomach and abforption continue for fome time ; the hair and nails grow, &c. The death of old age proceeds in a different inanner ; one fundtion is extinguished after another; circulation is ftopped firft in the fmaller, then in the larger veffels; in fhort, the death of old people proceeds from the periphery towards the centre, and the heart is the ultimum martens.
[ Virulenta, (vol. v. p. 383) has been already fo far gratified. An improper treatment of gonorrhoea is, doubtlefs, the moft frequent caufe of ftridlures, and therefore we may confider the treatment of ft rift u res in the urethra as forming alfo an important part of the cure of the venereal difeafe, or its confequencs. The male urethra has, with fufficient reafon, been called Pandora's box ; and ofail the evils it has produced, ftridlures, either immediately or in their confequences, may be confidered as the moft formidable and, diftrefiing. However " invidious," therefore, " it may appear to others, 480 Mr. Whately, on Strictures' in the XJrethra. others, or however painful to ourfelves," the author obferves, " it may be, to attack the opinions of a refpedtable chara&er; yet to be more influenced by a relu&ance to condemn the pra&ice of an individual than by a defire to relieve the thoufands of wretched beings around us, would be a reprehenfible delicacy." Our narrow limits do feldom permit us to do juftice to pra&ical works of this kind; and indeed our readers muil: long have obferved, that our objed is merely to point out and diftinguifh fuch new works as merit the attention of certain praftitioners, or the public in general. Now it is our opinion, that no furgeon who wifhes to do his duty to his patients in the bell manner in his power, will negleft to read Mr. W's pamphlets on Gonorrhoea and Strictures: That our readers, however, may have an opportunity of judging for themfelves, rather than relying 011 oujr authority only, we (hall, according to our cuftom, prefent them with a few extracts. After making fome remarks on the predifpofing caufe of ltri&ures in the urethra, Mr. W. proceeds " to inquire into the prefent method of treating certain cafes of them by the cauftic. My obfervations on this head are meant, fays he, to excite the attention of the reader to an improved method of treating the complaint in queftion. Fearing, however, left fo many publications on the cure of ftrittures of the urethra by the cauftic ftiould mislead the young pra&itioner, and caufe him to overlook what has been done, and what Hill may be done by a judicious management of the common bougie, I have judged it right, before I enter on the fubjett of cauftic applications, to make a few extracts refpefting the ufe of this Ample inftrument, from thofe excellent furgeons, Mr. S. Sharpe and Mr. Hunter. " Stri&ures in the urethra appear not to have been treated judicioufly, previous to the time of Monfieur Daran. Although the bougie had been ufed long before his time, it is to him we are indebted for a more extenfive and methodical application of it. Mr. Samuel Sharpe, and Mr. Hunter, have fince extended and brought to great perfection the ufe of this inftrument, by which a very diftreffing complaint has been, in many inftances, perfe&ly cured; and in the greater number of other cafes, it has been fo much alleviated by its occafional ufe, as to enable the patient to pafs through life without fuffering any ferious inconveniences from his infirmity. Both Mr. Sharpe and Mr. Hunter (particularly the latter) have given very excellent directions how to ufe this remedy, and have informed us upon what principle it adts." Mr. W. concludes his quotations from thefe authors, with the following from Mr. Hunter : " And in the following fe&ion he remarks, that " When a bou-*' gie can readily pafs, there is no neceffity for ufing any other " method to remove the ftridture." He then proceeds with great judgment to the treatment by cauftic of fuch ftridtures, " as are " either fo tight as not to allow the fmalleft bougie to pafsor of fuch, " as have not the orifice in the ftritture in a line with the " urethra, which will make it uncertain, if not impofiible, to " pafs >a bouo-ie." He likewife recommends the cauftic in thofe cafes cafes, in which " there may be no pafTage at all, it having been " obliterated by difeafe, and the urine pafied by fiftulse in.pe-? rin^o." " Mr, Hunter applied the cauftic in cafes of this defcription at firft by means of a filver canula; but, on account of many disadvantages attending this mode of ufing it, we are told by Mr, Home, that, for fome years before Mr, Hunter's death, he ufed it upon an improved plan, viz. by inferring a fmall piece of lunar cauftic into the end of a bougie, in fuch a manner, that the cauftic was furrounded every where laterally by the fubftance of the bougie ; fo that in its paffage to the ftri&ure, the oauftic was fcarcely allowed to come into contact with any part of the membrane of the urethra; the point of the bougie always moving in the middle line of the canal, " Mr. Home informs us, that, ever fince Mr. Hunter's death, he has continued to make ufe of the fame method of applying the cauftic; but it is evident from many parts of his work, that he employs commonly, for this purpofe, bougies of a much larger fize than thofe which were ufed by Mr. Hunter; and he feems to be defirous, in every cafe in which he adopts this method of treatment, to pafs through the ftri&ure a bougie, thus armed with cauftic, as large as the natural fize of the canal of the urethra. " Mr. Home has not only employed the cauftic in thofe cafes, in which it had been recommended by Mr. Hunter, but he has likewife ufed it in old ftri&ures, and fuch as cculd not be dilated to more than half the fize of the reft of the canal by the common bougie, and which, when dilated, were apt to contrail, and require a frefh application of the bougie within two months after it had been left off. Mr. Home therefore informs us, that his obfervations " will be confined entirely to the treatment of thofe ftricf tures which admit a fmall bougie to pafs into the bladder; and " that they are publiflied with a view to extend the ufe of the " cauftic to a greater variety of cafes, and in fome meafure upon. (e a different principle from that on which it was applied to imperrc vious ftritftures by the late Mr. Hunter." 'e The fubjedt is of great importance to thoufands aflli&ed with this malady. And as the propofed alteration in the plan of cure is by a remedy of a very violent nature, capable, if not ufed with great judgment, of producing confequences worfe than even the difeafe for which it is applied, it demands the moft ferious inveftigation. This I (hall now enter upon, by firft making a few obfer-Vations, concerning the manner in which ftridlures ufually affett the urethra, the number they commonly confift of in the fame perfon, and the part of the canal in which they are ufually fituate.
Our Author has not contented himfelf with common experience or observation, but has made a number of experiments with cauftic on vifible parts of the body, fuch as the infide of the cheek, which refemble the urethra in ftru&ure. He then fays, " Having endeavoured to fhew what are the probable effe&s of lunar cauftic, when applied to the inner membrane of the urethra in cafes of ftri&ure, by comparing its known effects when applied Nvwb. xxvit Qjj q to Dr. Hooper's Med. D'ltl. ? Dr. WUlarCs Reports. to parts that are open to obfervation, I ftiall proceed to point out the defeCts which appear in Mr. Home's method of ufing it, anil the confequences which fometimes refult from its being thus applied. After this I (hall, with all deference, propofe another mode of applying the Cauftic, which will, I apprehend, preclude every difagreeable effeCt that has hitherto attended the ufe of this powerful remedy. " I begin with obferving, that the orifice of the urethra is fo fmall in lome cafes of ftriCture, as not to admit the fmalleft bougie I have ever feen armed with cauftic. Of courfe, the cauftic cannot be applied to the ftriCture, while it is in this ftate. This contraction may arife, either from a natural conformation of the part, or from its having been the feat of chancres; or it may have come on gradually, from the long continuance of a ftriCture in any part of the urethra. If the contraction arife from the firft caufe, it may often be remedied by dividing the web at the orifice of the urethra ; but this mult render the part for fome time very tender, and in an unfit ftate to be ftretched by a large bougie. A contraction from the fecond caufe may frequently be dilated ; though it muft be confeifed, that, in fome of thefe cafes, it is impoffible to dilate it, fo far as to admit even the fmalleft fized armed bougie for the purpofe of applying the cauftic. Of this I have lately had an inftance. In the third cafe, dilatation is generally practicable, and it will remove the difficulty." The objections to Mr. Home's manner of applying the cauftic,. turn on fome of the following circumftances, viz.
The mucus of the urethra renders its aCtion uncertain.
The bougies are too large, and therefore only reach the anterior part of the ftriCture, or do injury if forced through it.
The cauftic is applied too often, and to too many ftriCtures at & time.
The confequences have often been ferious and alarming. Mr. W. next proceeds to deliver his own Method of treating

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of the world will find much ufeful and. important information in it.
The Nofology of feveral of the cutaneous difeafes will require a reference to Dr. Willan's elaborate work on that fuhjeft, of which we are forry to obferve, a part only is at prefent publilhcd. ' Br. W. gives the following account of the hiftory of the prefent volume. " A part of the following Reports was inferted in the Monthly Magazine for the years 1796, 1797, and in the Medical and Phyfical journal for 1799. Many of the readers of thofe periodical works having honoured with particular notice the ftatements refpe&ing Chronic Difeafes, as well as Epidemics, it was propofed to me that the monthly accounts of them fhould be reviled, and republifhed feparately, with any additional obfervations which might pccur.
' " With this proportion I have complied, finding myfelf unable through a variety of engagements, to accomplifh another object "which has been urged as a defirable one;?to give, under fome proper arrangement, an accurate hiftory of the diforders prevalent in or near London, from aftual o'ofervation, without any bias Irom the confideration of difeafes of other climates, and without a conftant reference to the congeries of fymptoms detailed by fyftematic writers.

"
In the prefent work, not only the accounts of difeafes for 1796, *797? and }799> are amplified, but Reports, entirely new, with various collateral obfervations, are added, for the year 1798; alfo for 1800, a year remarkable for its temperature, and for an unufual feries of complaints. Any irregularities which appear in the lifts of difeafes will, I hope, be excufed, a nice arrangement of them not having been the primary objeft. The gcneric diftin&ions and varieties muft be principally referred to the Nofology of Sauvages. In forming the three clanes of Acute, Chronic, and Periodical Difeafes, the ufual plan of nofologifts has not been obferved. All the writers on this fubjeft, Influenced, perhaps, by the opinion of Sydenham, have not only included fntermittents under the denomination of Fever, but Confidered one of their paroxyfms as an epitome of Fevers in general, the different forms of which, are faid to confift merely of a repetition of fuch paroxyfms more or lefs diftinftly marked with longer or (horter intervals. Thofe, however, who take the trouble to compare minutely the fymptoms of an Ague* and of a malignant Fever from contagion, will find that the primary appearances, the courfe, and crifis of the two difeafes are as different as their exciting caufes: and that no more analogy fubfifts between them than between the Small-pox, Eryiipeias, Rheumatifm, and internal Inflammation.

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Dr? IVillatfs Reports on the Diseases in London* bodily fun&ions, fo violent and general, that .unlefs they terminate favourably, or change their form, they muft prove fatal within 3 Ihort compafs of time. The fymptoms characterizing an acute difeafe at its commencement, and which have little remiffion during its courfe, are, fudden and confiderable lofs of ftrength, pain in the loins, aching of the limbs, total incapacity of attention or exertion of mind, heat of the fkin, thirft, a frequent pulfe, and furred tongue. Thefe general fymptoms, differently proportioned and varioufly modified, according to the ftrength, depreffion, or irregularity of the pulfe, the ftate of the mind, and appearances of the tongue, -iorm the fubdivifions and generic diitin&ions of febrile complaints. f " 2. Chronic Diseases are of long duration, and moftly confift of uneafinefs in fome part or organ, and of impediment to the performance of its functions. Theyare ufually attended with general debility, but not with violent diforder of the conftitution. " 3. Periodical Diseases are characterized by a return, at ftated intervals, of pain and general diforder, or fits of fhivering, followed by heat of the fkin, and perfpiration, the whole being comprifed in lefs than twenty-four hours. During the intervals* however, the patient is not in a ftate of health, but has 'a fallow complexion, and is afFeCted with languor, debility, lofs of appetite, &c? " Moft of the plans of nofology are exceptionable, as being formed on hypothetical principles, rather than a if rift analogy between the diieafes put m the fame order. It is not my prefent view to multiply objections, nor to enlarge on this fubjeft; 1 lhall only obferve that the difeafe, to which the denomination of Synochus is hereafter applied, has fome affinity with the Synochus of the antients.
This term is not employed by Dr. Cullen in its original fenfe, but to exprefs the combination of an inflammatory with a contagious Fever. The practitioners of North Britain haftily exclude from nofology, and feem to deny, the exiftence of a complaint with which their ftation does not lead them to be acquainted.
Occurs, and is very contagious, the title of Angina Maligna, would have been moll properly applied. Medical writers, by not diftinguilhing it from the Scarlatina anginofa, have been led into obfcurity, and made a foundation for fome needlefs controverfies. I may here alfo refer to the observations made on the complication of puerperal and malignant Fever, which has fome analogy with the cafes above ftated. " The term He&ica is ufcd in the fignification given to it by the Greek phyficians; among whom it was not conlidered merely as; a fecondary complaint, depending on internal fuppUration, or any local defeti, but as arifing from a failure of ftrength in old age> from an exhaulted ftate of conftitution, occafioned by fatigue,, long fading, anxiety, or lofs of deep; and fometimes as a fequel of Caufos or other Fevers. They remark farther, that the Hec-,tica often appears at firft like an Ephemera, that it is always aggravated after food, that its duration is indefinite, and that it often terminates in a marafmus. All the fpecies of Heftic are characterized by the recurrence every twenty-four hours, or fometimes. every twelve hours, of heat of the Ikin, after flight chillinefs, with a circumfcribed flufh of the cheeks, an increafed velo-.city of the pulfe, and violent perfpirations towards morning.? In infancy, childhood, youth, and old age, Hedlic takes place, without any local affection, from changes in the conftitution, connected with the different ftages of human life. A fimilar ftate of diforder is ofcen produced in perfons of the middle age, when the conftiiutional vigour firft appears to decline, not refilling as ufual the operation of cold, fatigue, and other occafional caufes. This ftate is moftly accompanied with aphthous ulcerations of the tongue and fauces, and a large lecretion of frothy phlegm. Under this ' head alfo muft be ranked the Febris aphthofa, or Hettica aphthofa, often put down in the fucceedinj lifts. It commences with violent and repeated fliiverings, fucceeded by flufhes of heat; with pains of the head, neck, and limbs; roughnefs of the throat; a dark rednefs and enlargement of the papilla; of the tongue; likewife an enlargement of the veins of the uvula, tonfils, &c. The for-: mation of aphthae is immediately followed by a drynefs of the tongue, clamminefs of the mouth, naufea, hiccough, heat in the ftomach, which is increafed by medicines, wine, or food, taken warm.
A Diarrhoea fupervenes, in which the ftools are of a dark brown colour, and often ftreaked with blood. The urine is at firft clear, but nas afterwards a curdly pink fediment, as in other hectic cafes. There is ufually pain and deafnefs in one ear, with great pain and tendernefs in the foles of the feet. A circumfcribed rednefs appears on the cheeks towards evening, attended w?th a quick pulfe, heat of the Ikin, flight delirium, and reftleflaefs. During the day the patient is Janguid and heavy, and fometimes thirity, with but little appetite. After the tongue, fauces, &c. have been healed, the Aphthous ulcerations return again, with internal heat, general uneafinefs, and the fame train of fymp'.oms as at firft. By frequent relapfes of this kind, the patient is often reduced to an extreme +36 Mr. Chevalier's Introduction to a Course of Lectures. extreme degree of debility and emaciation; and the whole duration of the complaint is from five to twelve weeks. The cafes of Hetfic, put down in the laft Report for the year i8co, were moftly of the kind here described. An account of this complaint was, by miftake, omitted in its proper place. v In the lifts of difeafes prefixed to the Reports, /two-thirds of the cafes occurred among the lower clafi'es of people, moftly patients of the Public Difpenfary, near Temple-Bar: the remaining third was the refillt of private pra&ice in the upper ranks of fociety. The increafed number of cafes put down for the laft two years muft be in a great meafure referred to the flourifhing ftate of the Difpenfary, by means of which the medical attendants became more fully acquainted with the difeafes of the diftrift; a diftritt extending from Smithfield and St. Paul's to St. Martin's Lane and Tottenham Court Road. " A comparative view of the Bills of Mortality, at different periods, and a diary of the weather, are given at the end of the book, as neceftary appendages to a work of this kind. The Meteorological Journal, taken from the Philofophical Tranfa&ions, was kept at the apartments of the Royal Society. It is to be noticed, that the quickfilver in the bafon of the barometer is ? i feet above the level of low water fpring-tides at Somerfet-Houfe." The obfervations interfperfed through the work are every where judicious and important, and the neceflary tables and indices are not omitted. Au Introduction to a Course of L eSlures on the Operations of Surgery ; by T. Chevalier, A.M. &c. 8vo. pp.58. London,i8ois Bagfter, Callow, &c. \ We advife every young man who wifhes to become a refpedlable furgeon, to read this ledture more than once. It embraces a concife view of the following fubje&s, viz. The natural endowments, acquired preparatory knowledge, neccfiity of anatomical knowledge, phyfiology, appearances of difeafe, juft reafoning, remedies, operations on the dead and living body. On this part of the duty of a good furgeon, Mr. C. points out a number of confiderations refpe&ing the circuinftances of the patient; the inftruments, unforefeen accidents during an operation, general rules for conducing an operation, the after treatment, and fupervening fever. Mr. C. concludes with inculcating the neceflity of induftry and diligence, from the commencement of his. ftudies to the end of a furgeon's profeliional labours. As a fpecimen of Mr. C's ftile and manner, we {hall prefent our readers with his obfervations on what regards the patient who is to undergo an operation. "* Having faid fo much on thofe things which lhould be attended to by a furgeon refpedting his own qualifications, let us now confider what is neceffary for him to regard refpedting his patient.
ff Before undertaking any important operation feveral things are to to be confidered. Thefe have been briefly expreffed in the following Latin verfe, which our forefathers have handed down to us: Quis, Quid, ubi, quibus auxiliis, cur, quomodo, quando.
" The ftate or condition of the patient is a matter of great importance, efpecially in thofe operations which are rendered neceffary by previous difeafe, and are not fuddenly required by ferious accidents.
It is proper efpecially to attend to his age, conftitution, and to the prefent Hate of his general health ; whether he be ftrong or debilitated, irritable and low; whether he appear fully equal to the operation, or whether there be any probability of his dying fooner in confequence of it. " With regard to the difeafe itfelf, not only its nature is to be taken into the account, but alfo its particular fituation ; the length of time it has continued, and whether it be fimpie qr accompanied with any peculiar circumftances which render a difference in the operation, or in the treatment, neceffary.
" Why the operation fhould be performed is another confideration. Is it abfolutely neceffary ? Is there any rifle incurred by it ? And if there be, Is the advantage expe&ed fully equal to that rifk ? and is the probability of fuccefs fufficient to juftify the expofure to it r